What are the responsibilities and job description for the Medicaid Analyst 1-3 position at LDH-Medical Vendor Administration?
About this Job
Learn more about the Louisiana Department of Health
The Medicaid Analyst (MA) is a position responsible for acquiring an extensive knowledge of Medicaid policy and procedures, and using the same tools to make timely and accurate Medicaid eligibility determinations.
The MA determines eligibility for health insurance to members and applicants in the manner of their choosing. The applications are received electronically by computer, by mail, by email, in person, or most often by telephone. This position requires competency in web-based programs. Work conditions are a combination of sedentary work on a computer, helping members by phone in a Call-Center format.
The successful candidate is an individual who works independently, is detail-oriented, has excellent customer service skills, can perform routine activities, is attentive to deadlines, is computer literate, is a team player, and has experience with high call volumes.
Medicaid eligibility is fundamental to the overall Medicaid program, and mastery of eligibility policy and procedure may be the first step in a path for career growth in the health insurance field.
Demonstrating Accountability: The ability to take ownership of actions, behaviors, performance, decisions, and outcomes.
Following Policies and Procedures: The ability to follow, reinforce, adapt, or develop policies and procedures to maintain compliance with federal and state legal requirements, State Civil Service rules, and organizational policies.
Minimum Qualifications
Three years of social services experience; OR
Six years of full-time experience in any field; OR
A bachelor's degree.
EXPERIENCE SUBSTITUTION:
Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.
Job Specification
The official job specifications for this role, as defined by the State Civil Service, can be found here.
Job Duties and Other Information
Job Duties:
Under close supervision, the entry level Medicaid Analyst learns to perform the following duties:
- The Medicaid Analyst (MA) is a position responsible for acquiring an extensive knowledge of Medicaid policy and procedures, and using the same tools to make timely and accurate
- The MA determines eligibility for health insurance to members and applicants in the manner of their choosing. The applications are received electronically by computer, by mail, by email, in person, or most often by telephone.
- Medicaid eligibility is fundamental to the overall Medicaid program, and the mastery of eligibility policy and procedure may be the first step in a path for career growth in health insurance field.
- Conducts interviews with clients and makes other necessary collateral contacts for verification in determining eligibility for Medicaid Programs. Examines application packets for timelines, completeness, and appropriateness prior to authorization of reimbursements.
- Makes decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the roll down procedure. Interprets and applies complex federal, state, and agency policies for each program.
- Conducts special investigations and complies reports concerning fraud and location of absent parents. Counsels and refers potentially eligible recipients or applicants to other agencies.
Position-Specific Details:
Medicaid Analyst 2 - $17.56 hr / $1,404.80 bi-weekly
Medicaid Analyst 3 – $21.27 hr / $1,701.60 bi-weekly
How To Apply:
Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.
Information to support your eligibility for the position must be included in the application (i.e., relevant, detailed experience/education). Resumes will not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.
Contact Information:
This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.
LDH supports Louisiana’s commitment to being a State as a Model Employer (SAME) by promoting the recruitment, hiring, and retention of individuals with disabilities.
Information on the Louisiana Works, Louisiana Rehabilitation Services is available here.
LDH is an equal opportunity employer and seeks to recruit a highly productive and diverse workforce and will provide equal employment opportunities to all employees and prospective employees. Employment decisions shall be based strictly on merit and without regard to religious or political beliefs, sex, race, or any other non-merit factor.
As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program:
Insurance Coverage More information can be found at https://info.groupbenefits.org/
Parental Leave – Up to six weeks paid parental leave
More information can be found at https://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx
Holidays and Leave – State employees receive the following paid holidays each year:
- New Year's Day
- Martin Luther King, Jr. Day,
- Mardi Gras,
- Good Friday,
- Memorial Day,
- Independence Day,
- Labor Day,
- Veteran's Day,
- Thanksgiving Day and Christmas Day.
State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.
Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works). These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to):
- Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video to give you more detailed information about their system
- Teacher's Retirement System of Louisiana (www.trsl.org),
- Louisiana School Employees Retirement System (www.lsers.net), among others
Salary : $2 - $18